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目的探讨老年脑出血急性期血压特征及其与近期预后的关系。方法采用前瞻性队列研究方法,连续登记2008年1月～2011年6月入院老年脑岀血患者。连续记录入院后7 d血压,在发病1月时评价预后,比较不同预后组入院急性期7 d内特征,并比较入院时和1个月时的改良Rankin量表评分(Modifi-cation of Rankin Scale,MRS)、美国国立卫生研究所脑出血评分(National Institute of Health Stroke Scale,NIHSS),并对数据进行分析。结果急性期7 d内平均收缩压与1月预后差呈U型关系,按不同平均收缩压亚组,平均收缩压在160～179 mmHg之间预后较好,MRS评分、NIHSS评分较低,相应1月改善显著;平均舒张压亚组与1月预后差之间这种U型效应消失,舒张压高,大于100 mmHg提示预后差,入院时不同舒张压亚组MRS和NIHSS评分差异不明显(P>0.05),MRS和NIHSS评分1月改善比较其差异显著(P<0.05)。结论老年脑岀血患者急性期7 d内平均收缩压在160～179 mmHg之间预后较好;急性期平均舒张压不能反映预测病情严重程度,但可反映预后转归倾向。
Objective To investigate the relationship between the characteristics of blood pressure in acute cerebral hemorrhage and its prognosis. Methods A prospective cohort study was conducted to register consecutively admitted patients with senile cerebral hemorrhage from January 2008 to June 2011. The blood pressure was recorded continuously 7 days after admission, and the prognosis was evaluated at January of onset. The characteristics of different prognosis groups within 7 days after admission were compared, and the Modific-Rank of Rankin Scale at admission and 1 month were compared. , MRS), the National Institutes of Health Stroke Scale (NIHSS), and analyzed the data. Results The average systolic blood pressure in 7 days of acute phase showed a U-shaped relationship with January prognosis. According to different mean systolic pressure subgroups, the average systolic blood pressure had a good prognosis between 160 and 179 mmHg. The MRS and NIHSS scores were lower, The U-shaped effect disappeared between the average diastolic pressure subgroup and the poor prognosis in January. The diastolic blood pressure was higher than 100 mmHg, which indicated that the prognosis was poor. There was no significant difference in MRS and NIHSS scores between different diastolic subgroups on admission P> 0.05). MRS and NIHSS scores were significantly improved in January (P <0.05). Conclusions The average systolic blood pressure in the elderly patients with cerebral hemorrhage within 7 days is good in the range of 160-179 mmHg. The average diastolic blood pressure in acute phase can not reflect the severity of the prognosis, but may reflect the prognosis of prognosis.